Prostate and Prostate Health
What is the prostate?
The prostate is a male sex gland that is important for reproduction in that it produces the majority of ejaculate fluid. It is a small walnut shaped gland that is located above the rectum and at the bottom of the bladder. The prostate surrounds the urethra (the tube that carries urine from the bladder) like a doughnut, at the point where the urethra connects to the bladder. The prostate gland continues to grow throughout most of a man's life.
How can prostate abnormalities be detected?
A rectal examination should be considered as part of the annual physical checkup for men beginning at age 50 years, unless there are factors that increase the risk of cancer (Afro-American, family history of prostate cancer, or working around cadmium), then the exams should start at age 40. By inserting a gloved finger in the rectum, the physician can feel the surface of the prostate through the wall of the bowel. Suspicious lumps, abnormal textures or hardness can be investigated through further testing. Unfortunately, there is no foolproof method of early detection.
Today, researchers are evaluating new technologies and laboratory tests that could possibly improve the early detection rate of prostate cancer and other prostatic diseases. One method is a blood test that measures concentrations of Prostate Specific Antigen (PSA), a protein produced in the prostate that may be elevated due to aging, if cancer is present, the prostate is enlarged or infected. Although some questions still exist over its use as a general screening tool, PSA levels may help a physician follow a patient with prostate problems over time. PSA , despite it's controversies, is the primary tool responsible for the increased incidence of detected prostate cancer. Currently there are a number of newer tests being evaluated that may enhance the PSA's accuracy to detect prostate cancer.
If at any age you notice changes in the way you normally urinate or in the appearance of your urine, or if ejaculation becomes painful, don't hesitate to report these observations to your family physician.
What are some common prostate abnormalities?
Prostate Cancer : Prostate cancer cannot always be felt by a physician during a digital rectal exam; this is especially true in the earliest stage of the disease. Another barrier to early detection is the fact that signs and symptoms that could alert the individual to a possible problem may not occur until the disease has reached a more advanced stage.
BPH : A condition called "enlarged" prostate or benign prostatic hypertrophy (BPH) is common later in life, affecting more than half of men in their 60s and as many as 90 percent of men in their 70s and 80s. The condition rarely develops before age 40. BPH is not cancerous, but many sufferers need some type of treatment at some point in their lives. Although enlargement of the prostate is an apparently normal part of aging, problems with urination that often accompany this enlargement are not normal. Enlarged prostate is often referred to as prostatism or benign prostatic hyperplasia (BPH). The signs of enlarged prostate are often the same as the signs and symptoms of prostate cancer.
BPH is much more common than prostate cancer. However, prostatism can be caused by prostate cancer, therefore it is important to get a professional medical opinion so the proper diagnosis can be made. The physician may also need to rule out prostate infection and other possible causes of the patient's symptoms.
Prostatitis: Is an inflammation of the prostate that can affect men of all ages. Some of the signs and symptoms are lower pelvic pressure and pain in the pubic area, pain during urination, and pain or uncomfortable feeling before or during ejaculation. One way to treat the symptoms is with antibiotics, but a urologist needs to rule out other possible causes of the signs and symptoms of each patient.
--------------------V Prostate Cancer V----------------
Prostate cancer is an endemic problem in the western world. The incidence of prostate cancer appears to be increasing. About 10% of men will get prostate cancer and approximately 4% die as a result. Studies of autopsies show that half of men over age 70 have some signs of prostate cancer, however these cancers are usually microscopic and are not detectable by clinical examination or biopsy.
Nobody knows what causes prostate cancer, but environmental factors appear to be important. Prostate cancer in Asia is significantly lower than in Europe, America and Australasia. The specific environmental causes are unclear, but evidence suggests that dietary fat may increase the risk, and lycopenes (found in tomatoes, especially rich in cooked tomato products) may reduce the risk of prostate cancer.
A known family history of prostate cancer may increase your risk of getting the disease. If one close relative has prostate cancer then your risk is 2-3 times greater. With 2 or more, the risk is 8 times.
The early symptoms are usually go undetected. There are no obvious symptoms. Advanced prostate cancer can cause symptoms like:
Sometimes pelvic pain can also occur. This is caused by compression on the urethra that carries urine out from your bladder by the enlarged prostate gland. Prostate cancer may spread to other parts of the body ("metastatic disease") it usually first appears in the pelvic lymph nodes. This normally does not cause symptoms. After the lymph nodes the second most common site for prostate cancer to attack are bone tissues. Typically patients can experience bony pain in the pelvis or lower back, or in many areas. The most common way prostate cancer is detected is in association with benign enlargement of the prostate. With benign enlargement of the prostate (BPH) you may experience a range of lower urinary tract symptoms, and prostate cancer may be diagnosed when you see a doctor about other problems with your urinary tract described above.
The screening debate
Currently controversy exists as to whether prostate cancer screening is appropriate. 10% of men will get clinical prostate cancer in their lifetime, and 2-4% die of it. Screening for prostate cancer is relatively simple to do, with an annual prostate examination and PSA test. Most patients with prostate cancer will be identified and with a relatively high chance of cure.
Screening is expensive if instituted nationwide. Potentially patients with relatively small, slow-growing prostate cancer tumours may be over-treated, and suffer dangerous side effects including the possibility of dying from the investigation and treatment itself. People who oppose prostate cancer screening also argue that there have not been any studies done that prove prostate cancer screening is effective. As of yet the issue of prostate cancer screening is unresolved, and no studies have been performed. Some indirect evidence that prostate cancer screening is effective are starting to appear in the USA, in some geographical areas where screening is popular, and death from prostate cancer is decreasing.
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PROSTATITIS
Bacterial infection of the prostate may be acute or chronic. A nonbacterial prostatitis is actually more common. (Merck Manual, 14th ed., pp 1566-1567) Saturation doses of vitamin C are at least as effective as antibiotics in any of these conditions. We know this through the work of Frederick R. Klenner, M.D., Robert Cathcart, M.D. and other physicians who have used very large doses of vitamin C to cure infections for decades. Vitamin C is admittedly nonspecific, but no more so than the pharmaceutical antibiotics that are given for infection no matter where in the body it may be. Vitamin C has the
advantages of being cheaper and considerably safer than drugs. Saturation of vitamin C is indicated by diarrhea, so one takes just less than the amount that would produce loose bowels. It will be a lot, measured in grams and not milligrams. The need for vitamin C will diminish as the infection subsides. A maintenance dose effectively helps to prevent a recurrence.
If there were a mineral that could be as important for the prostate as vitamin C is, it would be zinc. Infection or other stress results in lower blood serum zinc levels in general and lower prostate levels in particular. In prostatitis, zinc levels are only ONE-TENTH of those in a normal prostate. (Fair and Heston,1977; Pfeiffer, 1978) One time-tested prostate remedy is eating pumpkin seeds. It is no surprise that pumpkin seeds are a good source of zinc, as are shellfish (especially oysters, which would account for still more folklore) and nutritional yeast. A daily zinc supplement totaling 50 to 100 milligrams is frequently recommended in the natural healing literature, and that amount cannot be faulted by medical literature.
Since men lose zinc in every seminal emission, their need for the mineral is higher than a woman's. Research by Dr. Irving M. Bush and the Center for the Study of Prostatic Diseases in Chicago employed 50 to 100 mg of zinc per day for as long as 4 months to as little as only two weeks. There was prompt improvement in 70 per cent of the cases.
Not bad for just a single mineral. (Taylor, D. S. "Nutrients Can Remedy Prostate Problems," Today's Living, February 1990, pp 12-13)
BENIGN PROSTATIC HYPERTROPHY OR HYPERPLASIA (BPH)
The Merck Manual has historically indicated surgery as "definitive" therapy for this common condition. Medication is now commonly prescribed first, one of the more popular being finasteride ("Proscar") manufactured, conveniently enough, by the Merck company. Proscar is actually a somewhat dangerous substitute for an herbal remedy, as at least half of all pharmaceuticals are. The classic herb pirated in this case is the saw palmetto berry.
Saw palmetto is a shrub that grows down south in Georgia and Florida along the ocean. The leaves are palm-like, and the stems are saw-toothed, hence the name. According to The Herb Book by Dr. John Lust, a teaspoon of the dark-colored berries is steeped in one cup of water, and that is taken once or twice daily. There are no side effects or contraindications listed. This is in sharp contrast with the drug Proscar. Proscar has many serious side effects, and they are stated on the package insert, published in advertisements for the drug, and listed in the Physician's Desk Reference (PDR). The PDR is available in any bookstore or library, and you will find a copy at all drug counters. European studies have confirmed that saw palmetto berries are a statistically significant therapy for enlarged prostate. They are clearly a safer treatment, and cheaper as well. Even the American Medical Association is beginning to support the use of saw palmetto berry extract. About time!
Zinc is as helpful with enlarged prostates as it is with inflamed ones, since zinc deficiency results in prostate enlargement. Very few men obtain even the low US RDA of 15 milligrams of zinc a day, and this would explain a lot. Larger supplemental doses, commonly between 50 and 100 mg daily, may help shrink a swollen prostate. Toxicity
of zinc is very, very low and side effects of diarrhea and anemia begin at about 500 mg daily, vastly more than anyone would need to take. (Even at that level, supplemental iron and copper alleviate the side effects.) How effective is zinc therapy? Dr. Irving Bush (mentioned previously) of the Chicago Medical School and researchers from Cook County Hospital studied over 5,000 patients and have confirmed that zinc prevents prostate enlargement.
Vitamin C would almost certainly be of benefit to the enlarged prostate. At the very least, infection would be avoided and vitamin C's modest diuretic effect would probably make urination easier.
PROSTATE CANCER
This is the one we're really worried about, and there is much that can be done to prevent this number two cancer killer of American men (Wall Street Journal, April 22, 1992). Adequate zinc and abundant vitamin C both help to strengthen the body's immune system and prevent cancer. As mentioned above, optimum prostate health requires these nutrients in particular.
There is no doubt whatsoever that diet has a major role in allowing - or stopping - prostate cancer. A Harvard University School of Public Health study indicates that you are 250% more likely to suffer advanced prostate cancer if you eat red meat every day than if you eat red meat only once a week. The message is clear and generally ignored: move your diet in the direction of vegetarianism, and start today (USA Weekend, December 3-5, 1993, p 14).
Prostate cancer is very slow growing. Because of this, radical measures such as radiation or surgery are often reasonably postponed. This "watchful waiting," to see if surgery is truly needed, is advocated by more and more doctors. Obviously, regular medical examination and follow-up is important. Although there is question as to whether it actually saves lives, the Prostatic Specific Antigen (PSA) blood test is one way to monitor the prostate's condition. The actual benefits of surgery and radiation therapy are statistically quite small. After ten years, only slightly more of the treated patients are still alive than those that did nothing at all ("Prostate Cancer Cure Questioned," The Associated Press, January 27, 1994).
In the mean time, an especially good diet and appropriately generous use of supplements may positively influence the situation. It certainly cannot hurt to have lots of raw salad foods, sprouts, and fresh vegetable juices every day. Natural health research has continually emphasized these measures to help fight cancer. A particularly good example is the work of Max Gerson, M.D. Dr. Gerson used a mostly raw food and fresh vegetable juice diet for cancer patients with remarkably good results. He also used substantial quantities of vitamin supplements. His entire program is set forth in a tremendously valuable book he wrote called A Cancer Therapy: Results of 50 Cases (Gerson Institute, California). More recently, eating a lot of lycopene-rich, fresh tomatoes has been shown to radically reduce your prostate cancer risk.
Soy products appear to have a special benefit against prostate cancer. Japanese men have especially low death rates from prostate cancer, even thought they get the disease as often as American men do. The Japanese eat a lot of tofu, tempeh, miso, soy milk and other soy foods. Even animals fed a lot of soybeans have far less prostate cancer than others. There are at least two specific substances in soybeans that seem to help fight cancer: genistein and isoflavinoids. These natural chemicals are especially effective against the hormone-dependent cancers, which includes prostate cancer. ("Soybean Products May Lower Prostate Cancer," Lancaster Intelligencer-Journal, January 12, 1994)
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